| Lola Brognano, Lcsw, Llc | |
|
1882 Capital Cir Ne Ste 201 Tallahassee FL 32308-4568 | |
| (850) 888-0136 | |
| Not Available |
| Full Name | Lola Brognano, Lcsw, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1882 Capital Cir Ne Ste 201, Tallahassee, Florida |
| Authorized Official Name and Position | Lauren Brognano (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9208601938 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lola Brognano, Lcsw, Llc 491 Teal Ln Apt A Tallahassee FL 32308-4742 Ph: (920) 860-1938 | Lola Brognano, Lcsw, Llc 1882 Capital Cir Ne Ste 201 Tallahassee FL 32308-4568 Ph: (850) 888-0136 |
| NPI Number | 1710562848 |
|---|---|
| Provider Enumeration Date | 03/10/2021 |
| Last Update Date | 01/17/2022 |
| Certification Date | 01/17/2022 |
| Medicare PECOS PAC ID | 2668859695 |
|---|---|
| Medicare Enrollment ID | O20220513000329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710562848 | NPI | - | NPPES |
| 024870200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Lauren Lola Brognano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699120428 PECOS PAC ID: 3476817198 Enrollment ID: I20180504001910 |
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